No abstract

No abstract

No abstract

BackgroundLocomotor adaptability is based on the implementation of error-feedback information from previous perturbations to predictively adapt to expected perturbations (feedforward) and to facilitate reactive responses in recurring unexpected perturbations (‘savings’). The effect of aging on predictive and reactive adaptability is yet unclear. However, such understanding is fundamental for the design and application of effective interventions targeting fall prevention.MethodsWe systematically searched the Web of Science, MEDLINE, Embase and Science Direct databases as well as the reference lists of the eligible articles. A study was included if it addressed an investigation of the locomotor adaptability in response to repeated mechanical movement perturbations of healthy older adults (≥60 years). The weighted average effect size (WAES) of the general adaptability (adaptive motor responses to repeated perturbations) as well as predictive (after-effects) and reactive adaptation (feedback responses to a recurring unexpected perturbation) was calculated and tested for an overall effect. A subgroup analysis was performed regarding the factor age group [i.e., young (≤35 years) vs. older adults]. Furthermore, the methodological study quality was assessed.ResultsThe review process yielded 18 studies [1009 participants, 613 older adults (70 ± 4 years)], which used various kinds of locomotor tasks and perturbations. The WAES for the general locomotor adaptability was 1.21 [95 % confidence interval (CI) 0.68–1.74, n = 11] for the older and 1.39 (95 % CI 0.90–1.89, n = 10) for the young adults with a significant (p < 0.05) overall effect for both age groups and no significant subgroup differences. Similar results were found for the predictive (older: WAES 1.10, 95 % CI 0.37–1.83, n = 8; young: WAES 1.54, 95 % CI 0.11–2.97, n = 7) and reactive (older: WAES 1.09, 95 % CI 0.22–1.96, n = 5; young: WAES 1.35, 95 % CI 0.60–2.09, n = 5) adaptation featuring significant (p < 0.05) overall effects without subgroup differences. The average score of the methodological quality was 67 ± 8 %.ConclusionsThe present meta-analysis provides elaborate statistical evidence that locomotor adaptability in general and predictive and reactive adaptation in particular remain highly effective in the elderly, showing only minor, not statistically significant age-related deficits. Consequently, interventions which use adaptation and learning paradigms including the application of the mechanisms responsible for an effective predictive and reactive dynamic stability control may progressively improve older adults’ recovery performance and, thus, reduce their risk of falling.Electronic supplementary materialThe online version of this article (doi:10.1007/s40279-015-0413-9) contains supplementary material, which is available to authorized users.

The purpose of this study was to examine whether the human gastrocnemius medialis (GM) fascicle length and pennation angle alter during a sustained submaximal isometric plantar flexion. Fourteen male subjects performed maximal voluntary plantar flexions (MVC) on a dynamometer before and after a fatiguing task. This task consisted of a sustained submaximal isometric fatiguing contraction (40% MVC) until failure to hold the defined moment. Ultrasonography was used to visualise the muscle belly of the GM. Leg kinematics were recorded (120 Hz) to calculate the joint moment using inverse dynamics. The exerted moments and the EMG signals from GM and lateralis, soleus and tibialis anterior were measured at 1,080 Hz. The root mean square (RMS) of the EMG signal of the three triceps surae muscles increased significantly (P < or = 0.05) between 17% and 28% with fatigue. Further, the fascicle length of the GM significantly decreased from 47.1 +/- 8.0 mm at the beginning to 41.8 +/- 6.7 mm at the end of fatigue and the pennation angle increased from 23.5 +/- 4.1 degrees to 26.3 +/- 2.2 degrees (P < or = 0.05). The changes in fascicle length and pennation angle of the GM during the contraction can influence the force potential of the muscle due to the force-length relationship and the force transmission to the tendon. This provides evidence on that an additional mechanical mechanism, namely tendon creep, can contribute to the increase in the EMG activity of the GM during submaximal isometric sustained contractions.

Many studies report that muscle strength loss may alter the human system's capacity to generate rapid force for balance corrections after perturbations, leading to deficient recovery behaviours. Yet little is known regarding the effect of modifications in the neuromuscular system induced by fatigue on dynamic stability control during postural perturbations. This study investigates the effect of muscle strength decline induced by fatiguing contractions on the dynamic stability control of young and older adults during forward falls. Eleven young and eleven older male adults had to regain balance after sudden falls before and after submaximal fatiguing knee extension-flexion contractions. Young subjects had a higher margin of stability than older ones before and after the fatiguing task. This reflects their enhanced ability in using mechanisms for maintaining dynamic stability (i.e. a greater base of support). The margin of stability, the boundary of the base of support and the position of the extrapolated centre of mass, remained unaffected by the reduction in muscle strength induced by the fatiguing contractions, indicating an appropriate adjustment of the motor commands to compensate the deficit in muscle strength. Both young and older adults were able to counteract the decreased horizontal ground reaction forces after the fatiguing task by flexing their knee to a greater extent, leading to similar decreases in the horizontal velocity of centre of mass as in the pre fatigue condition. The results demonstrate the ability of the central nervous system to rapidly modify the execution of postural corrections including mechanisms for maintaining dynamic stability.

BackgroundPrevious studies from our group have shown that "pure" eccentric exercise performed on an isokinetic dynamometer can induce health-promoting effects that may improve quality of life. In order to investigate whether the benefits of "pure" eccentric exercise can be transferred to daily activities, a new and friendlier way to perform eccentric exercise had to be invented. To this end, we have proceeded to the design and construction of an automatic escalator, offering both stair descending (eccentric-biased) and stair ascending (concentric-biased) exercise.FindingsTwelve elderly males (60-70 yr) with chronic heart failure participated in the present study. Participants carried out six weeks of stair descending or ascending training on the novel SmartEscalator device. Muscle damage and performance indices were evaluated before and at day 2 post exercise at the first and sixth week of training. Both training regimes increased, albeit not significantly in some cases, eccentric, concentric and isometric torque. After six weeks of stair descending exercise, eccentric, concentric and isometric peak torque increased 12.3%, 7.7% and 8.8%, respectively, whereas after stair ascending exercise eccentric, concentric and isometric peak torque increased 7.1%, 9.6% and 5.9%, respectively.ConclusionsStair descending exercise appears to be a pleasant and mild activity that can be easily followed by the elderly. Compared to the more demanding stair ascending exercise, changes in muscle strength are similar or even greater. Elderly or people with impaired endurance wishing to increase their muscle strength may be benefited by participating in activities with strong eccentric component, such as stair descending.

No abstract